| NPI | 1033992896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN DARABI Office Manager 413-320-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2024-01-29 |